Opioid Message Fatigue in the United States: Prevalence and Associations with Stigma and Policy Support.
Authors: Harrell-Webber A, Chang WL, Eab-Aggrey N, Taylor BG, Lamuda PA, Pollack HA, Schneider JA, Taxman FS, Zhao X
Journal: Substance use & misuse
mental health
psychology
open access
Abstract
Children in sub-Saharan Africa (SSA) disproportionately experience a combined high burden of malnutrition and infection, which can cause clinical malaria. The first malaria vaccine (RTS,S) was prequalified by the WHO in 2022, followed by the R21 vaccine in 2023. These vaccines have only recently been introduced into routine care across malaria-endemic countries In SSA, and the global clinical malaria burden remains high. An estimated 282 million cases and 610,000 malaria deaths occurred in 2024 alone, of which more than 6 million cases and 16,000 deaths were estimated in Malawi. Children under 5 years old experience the greatest burden of severe malaria illness, accounting for ~75% of malaria deaths. Likewise, childhood malnutrition, which can manifest as underweight, wasting, or stunting, contributes to more than 3 million deaths among children under 5 years of age annually. Approximately 16% to 21 % of children under 5 years of age in SSA and between 12% and 18% in Malawi are underweight, defined as having a weight-for-age Z-score (WAZ) at least 2 SDs below child growth standards established by the WHO.
infection, regardless of whether it results In clinical malaria, and child malnutrition have been associated with downstream adverse health outcomes, including increased risk of all-cause mortality, subsequent growth Impairment, and cognitive impairment, highlighting the importance of addressing both health issues. To adequately address the underlying causes of child malnutrition and malaria, and reduce the burden of these two conditions, there is a need to characterize the directional relationship between malaria and growth impairment. The overlapping burden and risk factors for malaria and growth impairment, including socioeconomic factors, environmental and seasonal factors, and past or concurrent parasitic infections, add to the complexity of understanding their relationship. Although challenging, disentangling the temporal relationship between infection and child growth impairment using longitudinal data Is a crucial first step to informing causal inference assessments and shaping the implementation of effective interventions targeting both conditions. Past evidence regarding the associations between malaria and growth impairment has been mixed. Studies on malaria and growth impairment have frequently been cross-sectional and thus unable to establish temporality. Longitudinal studies have generally assessed whether growth impairment was a risk factor for subsequent malaria and have yielded mixed results. Some authors reported that growth impairment, including being underweight, increased the risk of subsequent malaria, indicating that interventions targeting growth impairment could help reduce subsequent malaria risk. Others, however, found no association when assessing weight over time. Additionally, there is evidence that infection is associated with increased risk of subsequent stunting and wasting, suggesting that preventing infection can improve child growth. Studies In which the impact of on infant weight was assessed, however, are either less common or revealed no significant association. There is a lack of studies in which the bidirectional associations between malaria and growth have been characterized within the same population.
infection, regardless of whether it results In clinical malaria, and child malnutrition have been associated with downstream adverse health outcomes, including increased risk of all-cause mortality, subsequent growth Impairment, and cognitive impairment, highlighting the importance of addressing both health issues. To adequately address the underlying causes of child malnutrition and malaria, and reduce the burden of these two conditions, there is a need to characterize the directional relationship between malaria and growth impairment. The overlapping burden and risk factors for malaria and growth impairment, including socioeconomic factors, environmental and seasonal factors, and past or concurrent parasitic infections, add to the complexity of understanding their relationship. Although challenging, disentangling the temporal relationship between infection and child growth impairment using longitudinal data Is a crucial first step to informing causal inference assessments and shaping the implementation of effective interventions targeting both conditions. Past evidence regarding the associations between malaria and growth impairment has been mixed. Studies on malaria and growth impairment have frequently been cross-sectional and thus unable to establish temporality. Longitudinal studies have generally assessed whether growth impairment was a risk factor for subsequent malaria and have yielded mixed results. Some authors reported that growth impairment, including being underweight, increased the risk of subsequent malaria, indicating that interventions targeting growth impairment could help reduce subsequent malaria risk. Others, however, found no association when assessing weight over time. Additionally, there is evidence that infection is associated with increased risk of subsequent stunting and wasting, suggesting that preventing infection can improve child growth. Studies In which the impact of on infant weight was assessed, however, are either less common or revealed no significant association. There is a lack of studies in which the bidirectional associations between malaria and growth have been characterized within the same population.